SBRT Treatment Planning: Practical Considerations

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Montefiore-Einstein Cancer Center <strong>SBRT</strong> Registry Study Lung Peripheral Lesions • Three fractions: 60 Gy (20 Gy per fraction) (Based on RTOG 0618) Central Lesions • Five fractions: 50 Gy (10 Gy per fraction) (Based on RTOG 0813) For Lung cases, it is often necessary to have non-coplanar beams to achieve fast dose fall off. We use three partial arc VMAT technique Each arc at least 100 degree Non-coplanar couch angle up to 20 degree Non-coplanar multiple IMRT or 3DCRT beams can be also used.
Arc2: Couch 15, Gantry 330-110 Arc1: Couch 0, Gantry 179-30 Arc3: Couch 345, Gantry 110-330 Arc 2 and Arc 3 are mostly anterior arcs to gain clearance
Page 1 and 2: SBRT Treatment Planning: Practical
Page 3 and 4: Outlines • The Basic Principles o
Page 5 and 6: Montefiore-Einstein SBRT Experience
Page 7 and 8: RTOG SBRT Protocols • 0631 Spine
Page 9 and 10: If beam margin is close to beam pen
Page 11 and 12: For single isocenter dose distribut
Page 13 and 14: Conventional SBRT (Ablative intent)
Page 15 and 16: For SBRT plans Prescription Isodose
Page 17 and 18: Requirements of SBRT Plan (from RTO
Page 19 and 20: The published protocols usually do
Page 21 and 22: 10cm Conventional Cord 10cm RTOG 06
Page 23 and 24: For Spine Cases: IMRT or VMAT is re
Page 25 and 26: Cord: Max point dose 9.33 Gy V100%
Page 27 and 28: Prescription Isodose Surface Covera
Page 29 and 30: Conformality : Prescription Dose Vo
Page 31 and 32: COR CAX SAG No need to do any non-c
Page 33 and 34: Single Arc Collimator 45 CAX Two Ar
Page 35 and 36: Additional 15 cc volume of normal t
Page 37 and 38: Fixed IMRT Fields 100% PD and above
Page 39: 9 Field IMRT: Cord Dose DVH 10 Gy 0
Page 43 and 44: Prescription Isodose Surface Covera
Page 45 and 46: High Dose Spillage PD = 100% = 20 G
Page 47 and 48: Intermediate Dose Spillage: R 50% a
Page 49 and 50: 12.5% isodose restricted mainly in
Page 51 and 52: Liver Montefiore-Einstein Cancer Ce
Page 53 and 54: Hepatocellular Carcinoma Five Fract
Page 55 and 56: SBRT CT simulation • For upper th
Page 57 and 58: SBRT T-Spine • CT scan has to eit
Page 59 and 60: SBRT Lung/Liver/Abdominal Cases •
Page 61 and 62: SBRT Lung/Liver/Abdominal Cases •
Page 63 and 64: GTV is 5mm too inferior (MLC acts a
Page 65 and 66: What is a ‘Dry Run’? • Treatm
Page 67 and 68: Acknowledgements • Physics Jin Sh

SBRT Treatment Planning: Practical Considerations

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